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Organization
HUNTSVILLE ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, PC
Active
Organization
HUNTSVILLE ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP BRENT ELLEDGE DMD (OWNER)
(256) 534-5028
Entity
Organization
Contact information
Practice address
2314 PANSY ST SW, HUNTSVILLE, AL 35801-3803
(256) 534-5028
(256) 534-5073
Mailing address
2314 PANSY ST SW, HUNTSVILLE, AL 35801-3803
(256) 534-5028
(256) 534-5073
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5313
AL
Other
Enumeration date
09/16/2006
Last updated
08/15/2007
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